fertility facts

Singapore’s birth rate is declining. In 2010, the total recorded live-birth is 37,967. This is a steep drop from the 46,997 babies recorded in 2000*. The fertility rate of our females has dipped from 1.60 in 2000 to 1.15 in year 2010* and the Chinese female remains the least “fertile” among all the other races. Although there has been an increase in marriages, there has also been a rising number of divorces which seems to nullify the expected growth in birth rate.

The low birth rate is influenced by many factors. Singaporeans both male and female are getting married at an older age, which makes child bearing a harder task. Younger couples are also putting off their child bearing plans in liew of their career and other personal pursuits. There is a sense that managing work and family commitments can be too much of a burden for many especially in face of the heavy financial needs in bringing up a child and possibly caring for their parents. Hence some couples prefer to be childless or wait until they are already comfortable in their careers which means they are usually in their late thirties and beyond. With remarriages, the age of the potential mother is even further increased.

Many of those who are actively trying are often finding it hard to juggle their hectic work schedules and lifestyle choices which make them less healthy than they could be and compromise their fertility. Conscious efforts to eat well, engage in adequate exercise and getting proper rest and recreation is indeed needed to ensure optimal pre-pregnancy health for both man and woman.

These couples are often advised by their specialists to prepare themselves physically and physiologically. Many infertile couples may suffer from some nutritional deficiency eg zinc deficiency. This mineral is essential for sperm and uterine development. Couples can take prenatal supplements to enhance the quality of eggs and sperms. Keeping one’s weight at the optimal BMI levels is also important as excessive or inadequate weight is related to diminished fertility as well.

Stress is the one of the main causes of infertility and couples need to find ways to contain their expectations of themselves and manage their emotions to help combat stress. Adequate time to rest, have adequate nutrients and regular exercise will definitely help to combat stress and improve fitness and reduce stress. Yoga, Pilates or Qigong aims to stretch out our often tensed muscles and improve blood circulation. These exercises allow practitioners to relax their mind, stimulate the body reflexes and is thought to promote balance in hormone levels. In a recent Harvard-based study, women participating in yoga and relaxation regimes nearly tripled their chances of achieving pregnancy.

Apart from the exercise therapy, treatments such as acupuncture, traditional medicine and osteopathy are all gaining popularity among infertile couples. Some studies have shown that acupuncture enhances the success rate of in vitro fertilization (IVF).

In some countries, women have been allowed to freeze their eggs during the prime years to preserve her fertility potential. This allows a form of “biological insurance” for the woman who might not have found her optimal partner with whom to have a child or who might just not be ready to try for a pregnancy even if she was in a stable relationship. This means that she would require IVF to achieve a pregnancy in the future. However in Singapore, Ministry of Health currently only allows women to freeze eggs for medical reasons, for example those who are about to undergo cancer therapy.

The success rate for assisted fertility programs depends largely on individuals within the couple. Both male and female partners should bear equal responsibility towards the process. The fertility specialist is able to assess one’s condition and how he or she can improve on their overall physical and mental health. I recently saw this saying, “In the storms of life, one must learn to dance in the rain”. This is so true in our efforts to create and grow a family, we must press on no matter what life throws at us and along the way learn to celebrate the experience!

Dr Ann Tan is the first Singaporean to hold the Diploma of Fetal Medicine from the Fetal Medicine Foundation. She presently serves on the Women’s Health Advisory Committee at the Health Promotion Board. Dr Ann Tan was a Public Service Commission Scholar, and has won several prestigious awards in her field of specialization.

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